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COVID-19 相关的毛霉菌病患者手术的气道管理、程序数据和院内死亡率记录。

Airway management, procedural data, and in-hospital mortality records of patients undergoing surgery for mucormycosis associated with coronavirus disease (COVID-19).

机构信息

Department of Onco-anaesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India.

Department of Preventive Oncology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

J Mycol Med. 2022 Nov;32(4):101307. doi: 10.1016/j.mycmed.2022.101307. Epub 2022 Jul 2.

Abstract

PURPOSE

Although unexpected airway difficulties are reported in patients with mucormycosis, the literature on airway management in patients with mucormycosis associated with Coronavirus disease is sparse.

METHODS

In this retrospective case record review of 57 patients who underwent surgery for mucormycosis associated with coronavirus disease, we aimed to evaluate the demographics, airway management, procedural data, and in-hospital mortality records.

RESULTS

Forty-one (71.9%) patients had a diagnosis of sino-nasal mucormycosis, fourteen (24.6%) patients had a diagnosis of rhino-orbital mucormycosis, and 2 (3.5%) patients had a diagnosis of palatal mucormycosis. A total of 44 (77.2%) patients had co-morbidities. The most common co-morbidities were diabetes mellitus in 42 (73.6%) patients, followed by hypertension in 21 (36.8%) patients, and acute kidney injury in 14 (28.1%) patients. We used the intubation difficulty scale score to assess intubating conditions. Intubation was easy to slightly difficult in 53 (92.9%) patients. In our study, mortality occurred in 7 (12.3%) patients. The median (range) mortality time was 60 (27-74) days. The median (range) time to hospital discharge was 53.5 (10-85) days. The median [interquartile range] age of discharged versus expired patients was 47.5 [41,57.5] versus 64 [47,70] years (P = 0.04), and median (interquartile range) D-dimer levels in discharged versus expired patients was 364 [213, 638] versus 2448 [408,3301] ng/mL (P = 0.03).

CONCLUSION

In patients undergoing surgery for mucormycosis associated with the coronavirus disease, airway management was easy to slightly difficult in most patients. Perioperative complications can be minimized by taking timely and precautionary measures.

摘要

目的

尽管有报道称患有毛霉菌病的患者会出现意外的气道困难,但有关冠状病毒疾病相关毛霉菌病患者气道管理的文献却很少。

方法

在对 57 例因冠状病毒疾病而行手术治疗的毛霉菌病患者的回顾性病历记录中,我们旨在评估患者的人口统计学特征、气道管理、手术过程数据以及院内死亡率记录。

结果

41 例(71.9%)患者被诊断为鼻窦毛霉菌病,14 例(24.6%)患者被诊断为鼻眶毛霉菌病,2 例(3.5%)患者被诊断为腭部毛霉菌病。共有 44 例(77.2%)患者存在合并症。最常见的合并症是 42 例(73.6%)患者的糖尿病,其次是 21 例(36.8%)患者的高血压和 14 例(28.1%)患者的急性肾损伤。我们使用插管困难评分量表来评估插管情况。53 例(92.9%)患者的插管条件为容易至稍有困难。在我们的研究中,有 7 例(12.3%)患者死亡。中位(范围)死亡率时间为 60(27-74)天。中位(范围)住院出院时间为 53.5(10-85)天。出院与死亡患者的中位(四分位距)年龄分别为 47.5(41,57.5)岁和 64(47,70)岁(P=0.04),出院与死亡患者的中位(四分位距)D-二聚体水平分别为 364(213,638)ng/ml 和 2448(408,3301)ng/ml(P=0.03)。

结论

在因冠状病毒疾病而行手术治疗的毛霉菌病患者中,大多数患者的气道管理为容易至稍有困难。通过及时采取预防措施,可以将围手术期并发症降到最低。

相似文献

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Anesthetic management of rhinoorbitocerebral mucormycosis; Focus on challenges.鼻眶脑毛霉菌病的麻醉管理;关注挑战。
J Mycol Med. 2019 Sep;29(3):219-222. doi: 10.1016/j.mycmed.2019.07.001. Epub 2019 Jul 26.

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